A tiny little European country that is the smallest in the world by size and population has a zero birth rate.

Spread over just 0.44 sq km with a population of just 825, Vatican is a small city-state and enclave located within Rome, Italy.

Given the unique status of Vatican City, the country is the only one in the world with a zero birth rate, meaning no one is ever born here. There are no healthcare systems, medical centres and no hospitals as the population is so small.

This means that all patients must access clinics and hospitals outside of the Vatican’s walls in Rome for care.

Vatican City has one single pharmacy which provides an essential service not only to Vatican locals but also to tourists. It’s located in the Belvedere Palace and is open to the public.

Eusebio Ludvig Fronmen, a Fatebenefratelli monk, who ran a nearby pharmacy, took charge of supplying medicines for the pope and cardinals residing in the Vatican in 187 .

Those who wish to move to the Vatican must have their citizenship approved by the Pope, or papal authority. A Vatican citizenship is provided on a ‘jus officii’ basis meaning someone is made a citizen of the Vatican when they are appointed to work in the Holy See. Their citizenship ends when their appointment ends.

However, some people disagree and believe that the odd baby must have been born within the Vatican’s walls.

One Quora user argues that “thousands of children are continuously being born there”.

The user believes that multiple births have occurred in St Peter’s Square as during old times women would flock to the square to give birth in belief they would be “protected from the elements there and they’d often receive a degree of Christian charity by visitors or the priests themselves”.

“There are also families living in the Vatican, for instance the families of some Swiss Guards. I guess we can assume that some of these wives gave birth on Vatican grounds in the old times”, the user added.

Another user shared a clipping from the The Evening News from San Jose, California, which states: “First Vatican City baby is named Pius. Vatican City, June 19 (AP). The first baby born in the new papal state is named Pio (pius). He is the son of a papal servant.”

A third claimed a homeless woman gave birth in St Peter’s Square in 2016, CBS News reports the incident happened “just beyond Vatican territory”.